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Objective: To evaluate the effectiveness of wearable device interventions (eg, Fitbit) to improve physical activity (PA) outcomes (eg, steps/day, moderate to vigorous physical activity [MVPA]) in populations diagnosed with cardiometabolic chronic disease. Data Source: Based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, an electronic search of 5 databases (Medline, PsychINFO, Scopus, Web of Science, and PubMed) was conducted. Study Inclusion and Exclusion Criteria: Randomized controlled trials (RCTs) published between January 2000 and May 2018 that used a wearable device for the full intervention in adults (18þ) diagnosed with a cardiometabolic chronic disease were included. Excluded trials included studies that used devices at pre-post only, devices that administered medication, and interventions with no prospective control group comparison. Data Extraction: Thirty-five studies examining 4528 participants met the inclusion criteria. Study quality and RCT risk of bias were assessed using the Cochrane Collaboration Tool. Data Synthesis: Meta-analyses to compute PA (eg, steps/day) and selected physical dispersion and summary effects were conducted using the raw unstandardized pooled mean difference (MD). Sensitivity analyses were examined. Results: Statistically significant increases in PA steps/day (MD ¼ 2592 steps/day; 95% confidence interval [CI]: 1689-3496) and MVPA min/wk (MD ¼ 36.31 min/wk; 95% CI: 18.33-54.29) were found for the intervention condition. Conclusion: Wearable devices positively impact physical health in clinical populations with cardiometabolic diseases. Future research using the most current technologies (eg, Fitbit) will serve to amplify these findings.

Androgen-deprivation therapy (ADT) for prostate cancer (PCa) has side effects that significantly impair health-related quality of life (HRQOL). Exercise ameliorates many side effects of ADT, but different modalities, particularly in the home-based setting, have not been well studied. In this study the authors randomly assigned 66 PCa survivors receiving ADT to 6 mo of home-based aerobic or resistance training. Psychosocial well-being and physical fitness were measured at baseline, 3 and 6 mo, and then 6 mo postintervention. Intention-to-treat analyses showed that fatigue and HRQOL were not significantly different between groups; however, in a per-protocol analysis the resistance-exercise training group demonstrated clinically significant improvements in HRQOL. Differential within-group effects on physical fitness were also observed at various time points. At all time points, the aerobic-training group engaged in significantly more physical activity than the resistance-training group, a finding that should be further examined given evidence-based guidelines for activity volume in cancer survivors.

The PHC appears effective in improving glycemic control. Further research is required to assess the effectiveness of specific program components, training, and supervision approaches and to determine the cost-effectiveness of PHC interventions.

Background Approximately 70% of mental health disorders appear prior to 25 years of age and can become chronic when ineffectively treated. Individuals between 18 and 25 years old are significantly more likely to experience mental health disorders, substance dependencies, and suicidality. Treatment progress, capitalizing on the tendencies of youth to communicate online, can strategically address depressive disorders. Objective We performed a randomized controlled trial (RCT) that compared online mindfulness-based cognitive behavioral therapy (CBT-M) combined with standard psychiatric care to standard psychiatric care alone in youth (18-30 years old) diagnosed with major depressive disorder. Methods Forty-five participants were randomly assigned to CBT-M and standard care (n=22) or to standard psychiatric care alone (n=23). All participants were provided standard psychiatric care (ie, 1 session per month), while participants in the experimental group received an additional intervention consisting of the CBT-M online software program. Interaction with online workbooks was combined with navigation coaching delivered by phone and secure text messaging. Results In a two-level linear mixed-effects model intention-to-treat analysis, significant between-group differences were found for the Beck Depression Inventory-II score (difference –8.54, P=.01), Quick Inventory of Depressive Symptoms score (difference –4.94, P=.001), Beck Anxiety Inventory score (difference –11.29, P<.001), and Brief Pain Inventory score (difference –1.99, P=.03), while marginal differences were found for the Five Facet Mindfulness Questionnaire–Nonjudging subscale (difference –2.68, P=.05). Conclusions These results confirm that youth depression can be effectively treated with online CBT-M that can be delivered with less geographic restriction. Trial Registration Clinical Trials.gov NCT03406052; https://www.clinicaltrials.gov/ct2/show/NCT03406052